Wednesday, June 25, 2008

Medical Equipment Costs

The Washington Post opines,
There is little doubt that Medicare has been paying far too much for equipment — including wheelchairs, hospital beds, oxygen concentrators, diabetic test kits, and walkers — under fee schedules based on historical charges. According to federal officials, Medicare currently pays $1,825 for a hospital bed that can be bought online for $754, and $4,023 for a power wheelchair that can be bought online for $2,174.
There's a big element missing from that price comparison. A local equipment vendor will often deliver equipment to a patient's home, set it up, and train the patient in its use. They often arrange service and repairs, and may offer a loaner unit while repairs are being conducted. A mail order vendor will add a shipping charge to deliver the item to your driveway, and that's about it.

I'm not arguing that there's not a lot of waste, or that some vendors may be charging too much for some of the services they provide, but I think the Post is grossly oversimplifying the issue and missing other potential areas for cost savings. For example, what happens to the hospital bed Medicare purchases after the patient dies or moves into a nursing home? Why aren't the beds, or other pieces of expensive equipment, collected, refurbished, and used for other patients?
Meanwhile, many patient-oriented groups have also called for a delay, apparently fearing that switching suppliers, perhaps from a local company with personalized service to a lower bidder elsewhere, could diminish the quality of service. These fears seem overblown and should be easily addressed in coming months, partly by strengthening oversight by ombudsmen and surveying beneficiaries to detect and remedy any problems.
Appointing an ombudsman does little to help a patient with an urgent health need. Surveys? Really.... The patient fears may be greater than are justified by the program, but if you're going to claim they can be "easily addressed" you should do just that rather than dismissing them.

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